Paper short abstract:

This paper analyzes framings of ‘chronic’ patienthood in eating disorders. It suggests that the discursive construction of some patients as ‘chronic’, amidst an overarching discourse of eating disorders as ‘curable’, materializes in ambiguous and cyclical clinical care.

Paper long abstract:

While eating disorders are not classified as chronic conditions, about thirty percent of eating disorders patients are labeled 'chronically ill'. This apparent paradox - the attribution of chronicity to individual patients, rather than to the disorder with which they are diagnosed - implicates a treatment landscape in which discussions of 'self-management', or living safely with an eating disorder, are largely absented. With eating disorders constructed as behavioural disorders to be 'cured', 'chronicity' is laden with moralizing discourses. Patients labeled 'chronic' are framed as non-compliant or lacking readiness to recover; and, within a system of clinical care targeted at recovery, these patients face repeated inpatient and outpatient treatment, often to little avail.

This paper analyzes constructions of 'chronicity' and care in eating disorders, drawing on interviews with long-term eating disorders patients from Israel and the UK, patient blogs, clinical articles on the management of chronic eating disorders, and instructional webpages (such as those provided on the NHS website) directed at eating disorders patients. The analysis highlights the challenges that 'chronicity' poses to biomedical concepts of eating disorders and recovery, and to clinical models of efficacious care; it also interrogates how the term 'chronic', when used in the context of a disorder framed as 'curable', weaves into patients' narrated experiences of stigma, risk, and resistance. Offering a multi-dimensional account of 'chronicity', this paper suggests that the discursive construction of some patients as 'chronic', amidst an overarching discourse of eating disorders as 'curable', materializes in ambiguous and cyclical clinical care.